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Method and system for quantifying influence of big disease medical insurance policy adjustment on fund expenditure

A quantitative method and policy technology, applied in finance, instruments, data processing applications, etc., can solve problems such as difficult to accurately calculate the impact of medical insurance funds

Inactive Publication Date: 2019-09-06
PACIFIC MEDICAL HEALTH MANAGEMENT CO LTD
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Problems solved by technology

[0003] Due to the complexity of medical insurance policies, ordinary calculation methods can only be estimated on an overall level, and it is difficult to accurately calculate the impact of medical insurance policy adjustments on medical insurance funds

Method used

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  • Method and system for quantifying influence of big disease medical insurance policy adjustment on fund expenditure
  • Method and system for quantifying influence of big disease medical insurance policy adjustment on fund expenditure
  • Method and system for quantifying influence of big disease medical insurance policy adjustment on fund expenditure

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Embodiment Construction

[0036] In order to make the purpose, technical solutions and advantages of the embodiments of the present invention clearer, the technical solutions in the embodiments of the present invention will be clearly and completely described below in conjunction with the drawings in the embodiments of the present invention. Obviously, the described embodiments It is a part of embodiments of the present invention, but not all embodiments. Based on the embodiments of the present invention, all other embodiments obtained by persons of ordinary skill in the art without creative efforts belong to the protection scope of the present invention.

[0037] Such as figure 1 As shown, this embodiment provides a quantitative method for the impact of major disease medical insurance policy adjustments on fund expenditures, which includes the following steps:

[0038] Step 101, collect samples: collect basic medical insurance reimbursement detailed data or critical illness reimbursement detailed dat...

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Abstract

The invention discloses a method and a system for quantifying the influence of big disease medical insurance policy adjustment on fund expenditure. The method comprises the following steps of collecting samples: collecting Basic medical insurance reimbursement detail data or serious illness reimbursement detail data of all insured persons in the recent medical insurance year and a serious illnessmedical insurance policy wherein the serious illness medical insurance policy comprises an original serious illness medical insurance policy and a new serious illness medical insurance policy corresponding to the medical insurance year; counting data: counting the accumulated large-disease medical insurance reimbursement amount of all insured people in the medical insurance year based on the original large-disease medical insurance policy; and carrying out modeling prediction: calculating the accumulated amount and the policy influence factor of the serious medical insurance to be reimbursed of all insured people of the medical insurance year based on the new policy under the new serious medical insurance policy so as to predict the amount of the serious medical insurance to be reimbursedof the future new policy.

Description

technical field [0001] The present invention relates to the technical field of critical illness medical insurance policy adjustment, in particular to a method and system for quantifying the influence of critical illness medical insurance policy adjustment on fund expenditure. Background technique [0002] With the establishment of the Medical Insurance Bureau and the continuous progress of medical reform, new medical insurance policies are frequently introduced, and the new policies have a huge impact on medical expenses. At the same time, the aging population and the continuous growth of per capita disposable income have increased medical expenses year by year, thus placing great pressure on the sustainable operation of medical insurance funds. By simulating the impact of medical insurance policies on the pooling fund and the amount of critical illness compensation under various scenarios, the adjustment of medical insurance policies is quantified, and the impact factors of...

Claims

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Application Information

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Patent Type & Authority Applications(China)
IPC IPC(8): G06Q40/08
CPCG06Q40/08
Inventor 左浩
Owner PACIFIC MEDICAL HEALTH MANAGEMENT CO LTD
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